From the Research
The MTP fusion healing process typically progresses through four main stages over 3-6 months, with the most critical factor being the avoidance of NSAIDs to prevent delayed union or nonunion, as evidenced by a recent meta-analysis 1. The stages of the MTP fusion healing process include:
- Inflammatory phase: characterized by pain, swelling, and the formation of a hematoma that brings healing cells to the fusion site, occurring during the first week post-surgery
- Soft callus formation: spanning weeks 1-3, where fibroblasts create collagen fibers to bridge the fusion gap
- Hard callus formation: occurring during weeks 3-12, where osteoblasts deposit calcium to create solid bone across the fusion site
- Remodeling phase: extending from 3 months to over a year, as the bone strengthens and adapts to weight-bearing forces During recovery, patients typically follow a progressive weight-bearing protocol, with pain management including short-term opioids like hydrocodone/acetaminophen (5/325mg every 4-6 hours) for severe pain in the first few days, and avoiding NSAIDs due to their negative effect on bone healing, as shown in a meta-analysis 1. Key considerations for the healing process include:
- Avoiding NSAIDs to prevent delayed union or nonunion, as they inhibit osteogenesis 1
- Using alternative pain management options, such as short-term opioids, to minimize the risk of delayed healing
- Following a progressive weight-bearing protocol to promote proper bone fusion and restoration of foot function, as described in a study on percutaneous MTP fusion 2